The Connect Care clinical information system (CIS) provides information about patients, as well as information about the delivery of care to those patients, always presented in "context". The context might be a clinical question, an encounter with healthcare providers, a stay in a healthcare facility, or a series of events linked in an episode of care.
The first step in any Connect Care clinical workflow must connect patient with context. Before looking up a patient, be aware of whether the purpose is to manage a visit (outpatient), admission (inpatient) or connected sequence of events (episode).
Getting this right matters. If a consultant in the emergency department evaluates a patient and starts Connect Care by looking up the patient rather than the consult, then actions like admitting the patient will be frustrated because the needed inpatient tools (e.g., admission navigator) will not be present.
Opening Charts in Context
When doing an emergency room consult...
Open the patient chart from the "Patient Lists" activity using a list of ER patients, a list of specialty consultations or the patient search box at the top right of the "Patient Lists" activity.
If the expected inpatient tools are not found, go to the "Select Encounter" activity and pick the ER encounter for the consult.
When seeing an admitted patient...
Open the patient chart from a list (favourite, system, team, etc.) in the "Patient Lists" activity, or look up from the search box at the top right of the "Patient Lists" activity.
When seeing a patient in clinic...
Open the patient chart from the Schedule workspace so that the correct encounter is also opened.
If looking up from the general Patient Lookup tool, be sure to also select the encounter of interest.
Determining Context of an Open Encounter
Once a patient chart is open, it is important to confirm that the context fits the work. Basic contexts (inpatient, outpatient) should be obvious from the chart layout upon opening.
An inpatient chart will have "Summary" as the activity tab immediately to the right of the "Chart Review" activity, and "Summary" is the default display upon opening the chart.
An outpatient chart will have "Snap Shot" as the activity tab immediately to the right of "Chart Review", and "Snap Shot" is the default display upon opening the chart.
There are other informational cues that reflect the context of an encounter entered upon opening a chart.
StoryBoard: Note the text just below the patient's name (and picture) at the top of the StoryBoard (leftmost column) of an open chart. Inpatients will have location information displayed under the MRN and ULI identifiers. Hovering over the patient identification block (with picture) will reveal a pop-up with facility location information included.
Chart Review Activity: The "Chart Review" activity is present as the leftmost tab of charts opened in most encounter types. Inpatients are flagged with a banner (pink background) indicating the patient's admission status.
Encounters Tab: The "Encounters" tab within the "Chart Review" activity lists encounters associated with the patient chart. Inpatient encounters are highlighted with a red font and a text indication of whether the admission is closed (discharged).
Patient charts can be opened in or out of a specific encounter. Either way, clinicians may want to review all encounters (known to Connect Care) to get a sense of a patient's interaction with the health system; or to find, open or change the chart context to a specific encounter.
The "Chart Review" activity is available (usually the leftmost chart tab) in all contexts. When selected, a number secondary tabs appear within the activity. The "Encounters" tab facilitates discovery of past, present and future encounters.
Note the power of the encounter "filter" function, which can help one to focus on inpatient, service-specific or prescriber-associated encounters. The filter defaults to "Hide additional encounters", a setting that removes some miscellaneous encounter types from view. When struggling to find a specific encounter or type (e.g., Intake Encounters), be sure to un-check this filter.
If a patient chart is open but does not have the expected layout, navigators or activities, there is a good chance that the chart has been opened outside of an encounter or opened to an unintended encounter. Changing encounters is easy. Use Search (top right and on StoryBoard) to jump to the "Select Encounter" activity, where a different encounter can be identified, selected and opened. The "Select Encounter" activity can also be found (and made a favourite) for the activity tabs that show when a chart is opened to an inpatient or outpatient context.
If a patient chart is not already open, using the "Patient Lookup" function (main menu or Chart Search for "Patient Lookup"), then an encounter can be selected at the time of opening a new chart by this means.